Psoriatic Arthritis (PsA)
Even though Psoriatic Arthritis (PsA) can occur in up to 1 in 3 patients with the skin disease Psoriasis, PsA is often underdiagnosed until significant joint damage has occurred. PsA is an autoimmune arthritis that often involves the joints and tendons of the body and may coexist with skin disease or in most cases develop after the skin disease is already present.
PsA can happen in young patients with psoriasis or may develop spontaneously in older patients.
The hallmark of Psoriatic Arthritis is tendon involvement or enthesitis (swelling and pain at the insertion point of tendons into bones).
Patients may report a history of:
Unexplained sudden knee pain often at the insertion of quadriceps muscle into the knee cap area
Nail deformity or changes including nail pits
‘Sausage fingers’, wherein a finger or a toe may swell up suddenly and stay that way for a few weeks, then spontaneously get better
Eye inflammation and pain
Joint swelling in hands and feet or low back
Psoriasis on skin esp on elbows and knees, around the scalp, or behind the ears
Importance of Diagnosis and Treatment:
Studies have shown that the diagnosis of psoriatic arthritis can be missed by doctors even in the presence of skin disease. So it’s important for dermatologists and GPs to be watchful for unexplained joint pains in patients with psoriasis or psoriasis-like skin disease.
If left untreated, PsA patients may have irreversible joint damage, leading to pain and disability. Not only that, but psoriatic arthritis patients also have a higher risk of developing metabolic syndrome (blood sugar, blood pressure, and cholesterol issues) and early heart disease.
There are many effective treatments for both the skin and joint components of psoriasis and psoriatic arthritis now which can reverse the skin disease and stop progression of joint damage. Please talk to your rheumatologist about treatment options for PsA.